Effects of different combinations of H2 receptor antagonist with gastrokinetic drugs on gastric fluid pH and volume in children--a comparative study.
In a prospective double-blind randomized study, 100 American Society of Anesthesiologists classification I (ASAI) children (aged 2-8 years) were allocated randomly to receive 1 of the 5 different oral premedicant combination, 2 hours before surgery. Group I (control) received placebo premedication, group II (RM) received ranitidine 2 mg/kg-1 with metoclopramide 0.2 mg/kg-1, group III (RD) received ranitidine 2 mg/kg-1 with domperidone 0.3 mg/kg-1, group IV (FM) received famotidine 0.5 mg/kg-1 with metoclopramide 0.2 mg/kg-1, and group V (FD) received famotidine 0.5 mg/kg-1 with domperidone 0.3 mg/kg-1. After tracheal intubation, gastric fluid was aspirated and analyzed for pH and total fluid volume. In 9 patients there was no aspirate, hence they were excluded from the study. Eighteen children from the control group and none of the children from other groups had gastric pH < 2.5 and volume > 0.4 ml/kg-1 (p < 0.01). Mean gastric pH (> 5.16) in RM, RD, FM, and FD groups was significantly higher as compared to control group (1.83) (p < 0.01). Mean gastric volume was significantly lower in RM, RD, FM, and FD groups (< 0.24 ml/kg-1) as compared to control group (0.5 ml/kg-1) (p < 0.01). Famotidine was found to be more effective in increasing gastric pH (p < 0.01) and decreasing volume (p < 0.05) as compared to ranitidine. No difference was found between metoclopramide and domperidone in increasing gastric pH and reducing gastric volume.
Kulkarni
P N
PN
Department of Anaesthesiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Batra
Y K
YK
Wig
J
J
D000932:Antiemetics / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D004294:Domperidone / Q000008:administration & dosage / Q000494:pharmacology; D004311:Double-Blind Method; D004338:Drug Combinations; D015738:Famotidine / Q000008:administration & dosage / Q000494:pharmacology; D005750:Gastric Juice / Q000737:chemistry*; D005766:Gastrointestinal Contents / Q000737:chemistry*; D006635:Histamine H2 Antagonists / Q000494:pharmacology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008787:Metoclopramide / Q000008:administration & dosage / Q000494:pharmacology; D011446:Prospective Studies; D011899:Ranitidine / Q000008:administration & dosage / Q000494:pharmacology; D011970:Receptors, Histamine H2 / Q000187:drug effects*
D000932:Antiemetics; D004338:Drug Combinations; D006635:Histamine H2 Antagonists; D011970:Receptors, Histamine H2; D004294:Domperidone; D015738:Famotidine; D011899:Ranitidine; D008787:Metoclopramide